Current Arthritis News and Research » Psoriatic Arthritis

How Early Should Psoriatic Arthritis be Treated?

awesome — Sun, 06 Jun 2010 02:46:03 +0000

A recent review of treatments for Psoriatic arthritis (PsA) found that the benefit of different therapies depended how widespread the disease was.

Psoriatic arthritis is the second most common cause of joint inflammation. It involves the skin and joints, but may also affect fingers and toes, eyes and the spine. The effect on the skin is seen as red, scaly patches on the skin. Erosion of the joints may occur within the first two years in nearly 50% of PsA patients. Furthermore, an erosion rate of 11% per year has been reported.

The researchers found that mild anti-inflammatories were only helpful if the disease was mild or localized. In cases were the joint involvement is more wide spread the more beneficial therapy is with disease-modifying antirheumatic drugs (DMARDs), such as methotrexate.

Further, in cases of extra-articular or spinal disease in which DMARDs have not shown significant benefit, biologic therapy (anti-Tumor Necrosis Factor or TNF) may be more effective.

This study suggests that optimal therapy with a combination of biologics and DMARDs may produce remission rates of up to 60%.

Findings of the review were published in the June 1st issue of Current Opinion in Rheumatology.

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FDA Investigates Link Between TNF Blockers and Cancer

awesome — Mon, 12 Apr 2010 19:22:15 +0000

The U.S. Food and Drug Administration has begun an investigation into links between anti-TNF (tumor necrosis factor) drugs, used to treat arthritis, and an increased risk of cancer in children. TNF blockers, sold under the names Enbrel, Remicade and Humira, are commonly used for the treatment of arthritis. The review is being conducted by the FDA’s Center for Drug Evaluation and Research.

The FDA has received 30 reports of cancer in children under the age of 18 who had been treated for JIA with anti-TNF drugs along with other medications, such as methotrexate, or similar immunosuppressant drugs.

Nearly 50% of the reports state the patients developed Hodgkin’s and non-Hodgkin’s lymphoma. The other reports indicate development of melanoma, leukemia and solid organ cancers.

Besides rheumatoid arthritis, TNF blockers are used to treat psoriatic arthritis, Crohn’s disease, plaque psoriasis, ankylosing spondylitis, as well as other diseases. TNF blockers are know to result in inflammation and weakening of the immune system.

The manufacturers of these drugs have been directed by the FDA to provide information about all TNF blocker recipients who have developed cancer, and in some cases to track cancer reports for 10 years. The FDA has also requested the assistance of medical professionals and patients in reporting any side effects from TNF blockers through the MedWatch Adverse Event Reporting program at www.fda.gov/medwatch/report.htm.

Originally posted 2008-06-06 22:25:05. Republished by Blog Post Promoter

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MRI Imaging Technique May Help Differentiate Arthritis

awesome — Sun, 04 Apr 2010 14:00:16 +0000

Rheumatoid arthritis (RA) is an auto-immune disease marked by inflammation of the joints and surrounding tissue. Psoriatic arthritis is a condition related to psoriasis, a chronic skin condition that is also an auto-immune disease. Psoriatic arthritis is usually confined to the knees, ankles, and joints in the feet.

Treatment for psoriatic arthritis has generally been based on that given for RA since the two are difficult to distinguish from each other. However, current research indicates that the type of therapy used, including medication, should to be tailored for each type of arthritis. A recent study has resulted in the ability to use imaging to correctly diagnose the diseases.

According to the study’s lead author, Nina F. Schwenzer, MD, “Clinically, it may be difficult to distinguish psoriatic arthritis from rheumatoid arthritis because the symptoms of both diseases are similar and the diagnostic tests currently available to aid in the differentiation of psoriatic and rheumatoid arthritis are not always sufficient.”

“The perfusion (or uptake) of contrast media in psoriatic arthritis and rheumatoid arthritis is presumed to be different,” said Dr. Schwenzer.

“Our study revealed a significant difference in perfusion between those patients with rheumatoid arthritis and psoriatic arthritis after 15 minutes. However, since it was a small group of patients and there was an overlap in perfusion values between both types of arthritis, a diagnosis could not be led by contrast-enhanced MRI alone. Our results are nonetheless promising though,” she said.

“As our study suggests, the use of contrast-enhanced MRI could play an important role in differentiating psoriatic arthritis from rheumatoid arthritis,” she said.

This study appears in the March issue of the American Journal of Roentgenology.

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Arthritis Drugs May Lead to Infection, Death

awesome — Mon, 01 Mar 2010 14:00:52 +0000

The FDA ordered that the class of drugs known as Tumor Necrosis Factor alpha blockers, which are also referred to as TNF blockers or anti-TNF, carry a warning on the packaging that their use carries the risk of developing a potentially deadly fungal disease called histoplasmosis. These drugs are marketed under the names Cimzia, Enbrel, Humira, and Remicade.

The packaging already is required to warn about fungal infections in general, but the new warnings will have to specifically call out histoplasmosis. This is a result of the FDA receiving reports of 240 patients who were taking TNF blockers that developed histoplasmosis. Of those 240, 45 patients died, including at least 12 who had not been immediately been diagnosed with histoplasmosis leading to a delay in treatment. The ages of these patients ranged from 8 to 86 years, however, none of the deaths involved children.

Histoplasmosis starts in the lungs and can spread to other organs in the body. If not treated in time, it can lead to death. In healthy people the body’s immune system is able to control the histoplasmosis infection. The risk is to people that have compromised immune systems, such as patients with AIDS or taking immune system suppressing drugs, such as alpha blockers.

The fungus that causes histoplasmosis, histoplasma capsulatum, is found throughout the world. It grows in the ground and in material that is contaminated with bat or bird droppings. Concentrations can be especially high in bird roosts, caves where bats roost and poultry house litter. Histoplasmosis is also more common in the Mississippi and Ohio River Valleys.

Symptoms of histoplasmosis include shortness of breath, fatigue, cough and fever.

Anti-TNF drugs are used to treat rheumatoid arthritis, psoriatic arthritis, plaque psoriasis, juvenile idiopathic arthritis, ankylosing spondylitis and Crohn’s disease.

The FDA published their directive on September 4th. You can read the actual release here

Originally posted 2008-09-06 18:46:48. Republished by Blog Post Promoter

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New Genetic Test May Predict Psoriatic Arthritis

awesome — Mon, 21 Dec 2009 14:00:32 +0000

Psoriatic arthritis is a joint disease developed by and estimated 20 to 40 percent of psoriasis patients. Detecting the disease in the early stages can provide an opportunity to administer treatments that can lessen the damage to the joints.

Pharmaceutical company PharmaGenoma, through its subsidiary PsoriasisDx, has developed a genetic test to assist doctors in identifying patients that are at risk for psoriatic arthritis before they show any symptoms. The company says that this is the first genetic test of its kind.

According to University of California, San Francisco (UCSF) Psoriasis expert Dr. John Koo,

“Until now, doctors have screened patients after the onset of the inflammatory arthritis. FDA approved medications for the treatment of psoriatic arthritis are most effective at controlling inflammation and arresting joint destruction, but are ineffective at reversing joint damage.”

The PsoriasisDX Genetic Test, which costs $399, uses a cheek swab to obtain the necessary genetic material. The sample is then sent for analysis to the PsoriasisDX laboratory which uses genetic sequencing to detect an immune response gene variant called MICA-A9. This gene variant is present in nearly 60 percent of psoriatic arthritis patients.

The relationship between MICA-A9 and psoriatic arthritis has been replicated by four peer-reviewed and published studies which involved over 900 patients from several ethnic populations.

If the PsoriasisDX Genetic Test shows positive results for the MICA-A9 variant, it means the patient has about a 60 percent chance of developing psoriatic arthritis. Alternatively, testing negative for MICA-A9 indicates that the patient has a 70 percent chance of not developing psoriatic arthritis.

It is hoped that testing for MICA-A9 will result in early detection of an increased risk of psoriatic arthritis and ensure that those patients who require intervention will receive them before inflammatory arthritis begins.

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